Prospective Treatment Efficacy in IPF Using Genotype for Nac Selection (PRECISIONS) Trial

NCT ID: NCT04300920

Last Updated: 2025-05-29

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

ACTIVE_NOT_RECRUITING

Clinical Phase

PHASE3

Total Enrollment

202 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-12-17

Study Completion Date

2026-02-27

Brief Summary

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The purpose of this study is to compare the effect of n-acetylcysteine (NAC) plus standard care with matched placebo plus standard of care in patients diagnosed with idiopathic pulmonary fibrosis (IPF) who have the TOLLIP rs3750920 TT genotype. The study will compare the time to a composite endpoint of relative decline in lung function \[10% relative decline in forced vital capacity (FVC), first respiratory hospitalization, lung transplantation, or all-cause mortality\]

The secondary objectives will be to examine the effect of NAC on the components of the primary composite endpoint, the rates of clinical events, change in physiology, change in health status, and change in respiratory symptoms.

Detailed Description

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This is a multi-center, randomized, double-blind, placebo-controlled trial of NAC or placebo in about 200 participants with IPF with a TOLLIP rs3750920 TT genotype.

Eligible participants will be randomized in a 1:1 fashion to NAC or placebo, stratified by stable concomitant IPF therapy use (i.e., pirfenidone or nintedanib administered for at least 6 weeks prior to screening) versus no pirfenidone or nintedanib use. Participants will receive 600 mg NAC orally or matched placebo to take three times daily for 24 months.

Conditions

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Idiopathic Pulmonary Fibrosis

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Eligible participants will be randomized in a 1:1 fashion to NAC or placebo, stratified by stable concomitant IPF therapy use (i.e., pirfenidone or nintedanib administered for at least 6 weeks prior to screening) versus no pirfenidone or nintedanib use. Participants will receive 600 mg NAC orally three times daily or matched placebo for 24 months.
Primary Study Purpose

TREATMENT

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors
The participant and site personnel will not know which study treatment the participant is receiving.

Study Groups

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N-acetylcysteine

600 mg oral N-acetylcysteine (NAC) three times daily for 24 months.

Group Type EXPERIMENTAL

N-acetyl cysteine

Intervention Type DRUG

600 mg N-acetylcysteine (NAC) oral tablets three times daily for 24 months.

Placebo

Placebo tablet three times daily for 24 months.

Group Type PLACEBO_COMPARATOR

Placebo

Intervention Type DRUG

Matching oral placebo tablet three times daily for 24 months.

Interventions

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N-acetyl cysteine

600 mg N-acetylcysteine (NAC) oral tablets three times daily for 24 months.

Intervention Type DRUG

Placebo

Matching oral placebo tablet three times daily for 24 months.

Intervention Type DRUG

Other Intervention Names

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NAC

Eligibility Criteria

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Inclusion Criteria

* ≥ 40 years of age
* Diagnosed with IPF according to 2018 ATS/ERS/JRS/ALAT, confirmed by enrolling investigator
* Signed informed consent
* If taking pirfenidone or nintedanib, must be on stable dose for at least 6 weeks prior to enrollment visit
* Confirmed rs3570920 TT TOLLIP genotype

Exclusion Criteria

* Pregnancy or planning to become pregnant
* Women of childbearing potential not willing to remain abstinent (refrain from heterosexual intercourse) or use two adequate methods of contraception, including at least one method with a failure rate of \<1% per year during study participation
* Significant medical, surgical or psychiatric illness that in the opinion of the investigator would affect subject safety, including liver and renal failure
* Receipt of an investigational drug or biological agent within the previous 4 weeks of the screening visit or 5 times the half-life, if longer
* Supplemental or prescribed NAC therapy within 60 days of enrollment
* Listed for lung transplantation at the time of screening
* History of lung cancer
* Inability to perform spirometry
* Forced vital capacity (FVC) less than 45% predicted, using the global lung function index (GLI) equation at Visit 1
* Active respiratory infection requiring treatment with antibiotics within 4 weeks of Visit 1
Minimum Eligible Age

40 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Virginia

OTHER

Sponsor Role collaborator

University of Michigan

OTHER

Sponsor Role collaborator

Pulmonary Fibrosis Foundation

OTHER

Sponsor Role collaborator

University of Washington

OTHER

Sponsor Role collaborator

National Heart, Lung, and Blood Institute (NHLBI)

NIH

Sponsor Role collaborator

Three Lakes Foundation

UNKNOWN

Sponsor Role collaborator

Fernando J Martinez

OTHER

Sponsor Role lead

Responsible Party

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Fernando J Martinez

Professor

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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Fernando J Martinez, MD

Role: PRINCIPAL_INVESTIGATOR

University of Massachusetts Chan Medical School

Imre Noth, MD

Role: PRINCIPAL_INVESTIGATOR

University of Virginia

Kevin Flaherty, MS, MD

Role: PRINCIPAL_INVESTIGATOR

University of Michigan

Cathie Spino, ScD

Role: PRINCIPAL_INVESTIGATOR

University of Michigan

Locations

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University of Arizona

Tucson, Arizona, United States

Site Status

University of Southern California

Los Angeles, California, United States

Site Status

Stanford University

Stanford, California, United States

Site Status

University of Colorado

Aurora, Colorado, United States

Site Status

Piedmont Healthcare

Austell, Georgia, United States

Site Status

University of Chicago

Chicago, Illinois, United States

Site Status

Loyola University

Maywood, Illinois, United States

Site Status

Indiana University

Indianapolis, Indiana, United States

Site Status

University of Kansas Medical Center

Kansas City, Kansas, United States

Site Status

Tulane University

New Orleans, Louisiana, United States

Site Status

Massachusetts General Hospital

Boston, Massachusetts, United States

Site Status

University of Michigan

Ann Arbor, Michigan, United States

Site Status

University of Minnesota

Minneapolis, Minnesota, United States

Site Status

Mayo Clinic

Rochester, Minnesota, United States

Site Status

Weill Cornell Medicine

New York, New York, United States

Site Status

University of Rochester

Rochester, New York, United States

Site Status

Ohio State University

Columbus, Ohio, United States

Site Status

Temple University

Philadelphia, Pennsylvania, United States

Site Status

Medical University of South Carolina

Charleston, South Carolina, United States

Site Status

Lisa Lancaster

Nashville, Tennessee, United States

Site Status

University of Texas Southwestern

Dallas, Texas, United States

Site Status

University of Texas Health San Antonio

San Antonio, Texas, United States

Site Status

University of Utah Health

Salt Lake City, Utah, United States

Site Status

University of Virginia

Charlottesville, Virginia, United States

Site Status

University of Washington

Seattle, Washington, United States

Site Status

Countries

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United States

References

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Podolanczuk AJ, Kim JS, Cooper CB, Lasky JA, Murray S, Oldham JM, Raghu G, Flaherty KR, Spino C, Noth I, Martinez FJ; PRECISIONS Study Team. Design and rationale for the prospective treatment efficacy in IPF using genotype for NAC selection (PRECISIONS) clinical trial. BMC Pulm Med. 2022 Dec 13;22(1):475. doi: 10.1186/s12890-022-02281-8.

Reference Type DERIVED
PMID: 36514019 (View on PubMed)

Other Identifiers

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1U24HL145265-01A1

Identifier Type: NIH

Identifier Source: secondary_id

View Link

19-12021232

Identifier Type: -

Identifier Source: org_study_id

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